Traumatic brain injury (TBI) is the leading cause of death among individuals under the age of 44 in industrialized countries. In Colombia, 70% of the emergency department visits are due to trauma, 51% of which are road traffic incidents. Around 43.9% of the events were motorbike accidents. The disability caused by this kind of accidents is not well documented. We performed a two-phase transversal study to characterize the neurological profile of motorcycle drivers at the moment of the accident (phase I) and 6 months after suffering a TBI (phase II) between 2014-2016 in clinics from the metropolitan area of Medellin, Colombia. During phase I, 645 patients histories were evaluated using the Glasgow coma scale to assess TBI severity. In phase II, 102 patients that met the inclusion criteria were neurological evaluated in the clinic 6 months after the accident. The primary outcome measures were the presence of sequelae immediately after the accident and 6 months later. We determined the factors that modulated TBI severity with a logistic regression. A conjoint analysis was made to establish the factors associated with sequels. We found in phase one that female sex was a protective factor against severe TBI, while any open TBI, the presence of more than one hematoma and loss of consciousness were classified as risk factors for severe TBI. The phase II study showed the highest amount of sequelae in patients classified as severe TBI, followed by mild TBI, and then moderate TBI. Patients at highest risk of developing sequelae were male, motorcycle drivers with frontal trauma, closed trauma, without loss of consciousness, mild TBI and receiving care at a high complexity institution. 68% of all patients presented with some sequels. The most common sequelae were headaches and equilibrium disturbances. The Glasgow coma scale did not correlate with a worse prognosis or the occurrence of sequels, which questions the usefulness of the scale when assessing TBI severity.

Sequels and clinical profile of traumatic brain injury in motorcycle drivers in the metropolitan area of Medellin, Colombia